I/We
the undersigned parent(s)/guardian(s) certify that Camper
has been examined by a licensed physician within the
school year of 2011–2012 and according to physician,
is free from any illness, injury or condition which
would limit participation in the activities conducted
by the Jim Kelly Celebrity Football Camp, Inc. (JKFC)
I/We also confirm that all the above information is
complete, accurate and correct to the best of my/our
knowledge. I/We also hereby authorize the staff of JKFC
to act in my/our behalf and for me/us according to their
best judgment in a situation requiring first aid or
medical attention for Camper. If such a situation arises,
I/we authorize said persons to request pertinent medical
information on my/our behalf and I/we hereby release
those providing such information from any liability
that might result. I/We hereby recognize that, although
JKFC is a non-contact instructional endeavor, participation
requires strenuous physical activity, which can result
in unintentional contact and exposure to injury, impairment
or the aggravation of any preexisting condition (s).
I/We hereby release, discharge, hold harmless and promise
to indemnify Jim Kelly, JKFC and its sponsors and staff,
Jim Kelly Enterprises, Inc., Buffalo Bills, Erie County,
and their trustees, officers, employees and agents from
any and all causes, liabilities, damages, claims or
demands whatsoever on account of any injury (including
death) or accident involving Camper arising out of Camper's
participation in the 2011-2012 JKFC. I/We authorize JKFC
to use any and all photographs, video or other images
of any kind for the purpose of promoting JKFC. JKFC
reserves the right, in its sole discretion, to accept
or not accept any application for enrollment. The full
deposit will be returned accompanying any application,
which is not accepted for whatever reason. It is the
intention of JKFC to exercise its discretion in this
regard with a view to the health and safety of all camp
participants.
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